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Systemic sarcoidosis presenting initially with bilateral orbital and upper lid masses
R K Imes1, J S Reifschneider, L E O'Connor
1Department of Ophthalmology, Naval Hospital, Oakland, California 94627.
Annals of Ophthalmology
|December 1, 1988
Summary
Systemic sarcoidosis can manifest as orbital masses, affecting eye muscles and optic nerves. Diagnosis requires biopsy and imaging, confirming noncaseating granulomas and systemic involvement.
Area of Science:
- Ophthalmology
- Rheumatology
- Pathology
Background:
- Systemic sarcoidosis is a multisystem inflammatory disease characterized by noncaseating granulomas.
- Ocular involvement is common in sarcoidosis, but orbital and eyelid masses are less frequent presentations.
Observation:
- A patient presented with bilateral orbital and upper eyelid masses.
- CT imaging revealed orbital masses, rectus muscle thickening, globe cuffing, and optic nerve sheath thickening.
- Biopsy of an eyelid mass confirmed noncaseating granulomas.
Findings:
- The patient was diagnosed with systemic sarcoidosis based on ocular findings, biopsy results, bilateral pulmonary hilar lymphadenopathy, positive gallium scan, anergy, and erythema nodosum.
- Ocular manifestations included bilateral anterior orbital and upper lid masses, diffuse rectus muscle thickening, globe involvement, and optic nerve sheath thickening.
Implications:
- This case highlights the importance of considering sarcoidosis in the differential diagnosis of orbital masses.
- Early recognition and diagnosis of systemic sarcoidosis are crucial for appropriate management and to prevent potential complications.
- Ophthalmologists and rheumatologists should be aware of the diverse ocular presentations of sarcoidosis.